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Can your HbA1c keep going down?

L

Lizzie2

Well-Known Member
Messages
70
Type of diabetes
Type 2
I've got mine reduced to 38mmol /5.6% and I'm now no longer considered to be T2. I'm obviously not going to start eating the sort of carbs and food that got me to being T2 in the first place but by staying on a LCHF and exercising every day will my HbA1c go down further? I've noticed on here that some people's results seem to have reduced even once they were no longer T2.

I'm also using an AccuChek Mobile meter, I don't think I need to check my bloods quite so often although I need to read up and see what is recommended as my next step - but I've read comments saying that the AccuChek Mobile works best when used every day and although it is brilliant it is quite expensive to run - can anyone suggest an other monitor that would be simple to use and cheaper to run.

I don't feel I can ask the diabetes nurse - especially as I won't be seeing her again until I'm tested again next year - because I wasn't sure if she approved of me just buying a monitor and testing before and two hours after every meal not to mention being on LCHF - I was supposed to be on 'diet and exercise' and was given the government 'healthy plate and eat carbs with every meal'diet sheets - she listened to what I said I had been doing for the last three months then said 'so you're basically following a low GI diet'
 
I don't know. I'll let you know when I get the result of my blood test from last week. The last three have been 88, 32 and 26.

I'm still somebody who suffers from Type 2 Diabetes, and although I currently have excellent control I still have the disease and if I went back to eating the diet I was prior to diagnosis I would certainly lose that control quite quickly.
 
@Lizzie2 and @britishpub those are excellent results. I am nowhere near you guys as am only starting on this journey but have moved from HbA1c of 97 at start of the year to 49 at end of March, and will be working hard to get it lower.

I agree with @britishpub, even if I manage to get my HBA1C below 40 I will not think of myself as "cured" but of having very good control over a permanent disease. I know that, psychologically, if I told myself I was cured I would revert to bad habits very quickly, no matter how good my intentions!

I haven't read enough about it, but is there a point below which your HBA1C shouldn't go? A bit like BMI, bad to be over 25 but also bad to be under 18? (Possibly a poor example as I don't think BMI figures are that useful., but you know what I mean )
 
Lizzie2 said:
I've got mine reduced to 38mmol /5.6% and I'm now no longer considered to be T2. I'm obviously not going to start eating the sort of carbs and food that got me to being T2 in the first place but by staying on a LCHF and exercising every day will my HbA1c go down further? I've noticed on here that some people's results seem to have reduced even once they were no longer T2.

I'm also using an AccuChek Mobile meter, I don't think I need to check my bloods quite so often although I need to read up and see what is recommended as my next step - but I've read comments saying that the AccuChek Mobile works best when used every day and although it is brilliant it is quite expensive to run - can anyone suggest an other monitor that would be simple to use and cheaper to run.

I don't feel I can ask the diabetes nurse - especially as I won't be seeing her again until I'm tested again next year - because I wasn't sure if she approved of me just buying a monitor and testing before and two hours after every meal not to mention being on LCHF - I was supposed to be on 'diet and exercise' and was given the government 'healthy plate and eat carbs with every meal'diet sheets - she listened to what I said I had been doing for the last three months then said 'so you're basically following a low GI diet'
Click to expand...

It can go lower, it depends really on what you want.
It's in the normal range, so why do you want it lower?

You have the same number as I've had for the past few years in fact, I feel good, I have no complications, I'm very relaxed over what I eat, and my diabetes now is not anything I worry about to be honest.

All I do is keep the weight off, and exercise.

(Thinking about it, I don't feel good when my BG drops below high 4's, so I guess by that I wouldn't like to see my hba1c much lower, as it'll mean I'll be in the 4's regularly)
 
Thanks everyone. Amazing results for you both TooManyCrisps and British Pub. Bet you feel really pleased with yourselves. It is so satisfying to get your blood sugar reduced.

I don't think of myself as 'cured' either - I'm sure I'm only 'cured' as long as I don't go back to my former carb laden diet - even though on the surface I only ate healthy stuff my portions were too large and I ate too many carbs and too much high sugar fruit, hopefully thinking about that way will keep me in the straight and narrow - as does the thought of ending up having to take pills and possibly even insulin.

SunnyExpat, you're right, as long as I'm in the normal range it doesn't matter. Part of me just wondered if your bloods kept going down the longer you stay carb free.

I'm fairly relaxed about what I eat now - I now know the sort of foods that will cause a spike and the sort of things that won't so within those ranges and being aware of portion control I'm relaxed. :)
 
There are some organs in our bodies that cannot burn fat for energy. Thr brain and respiratory system are the major ones. The body has many different pathways it can use to protect these organs when bgl drops. We could go zero carbs (theoretically that is) but must have protein in our diet to compensate. Prolonged LCHF will deplete our glucogen stores, and exercise will further use up any spare glucose sources, so our bgl will drop into hypoland, and this is the final warning. It makes us feel ****** and crabby (as per my avatar) and we normally respond by upping our carbs. Thus we can run with lower HbA1c levels, but there comes a point where we need to change things and have some carbs or extra protein to stave off the hypo's. Upping the fat will not do it since it cannot be used to replace the glucogen sources for the brain.
 
Thank OV, that's very useful to know. I love your avatar, there are some wonderful grumpy cats around. Cats don't even need a grumpy face to tell you how it is. I always knew when my cat used to turn his back in me and if he ruffled his fur while his back was turned to me then I knew I'd really upset him big time.
I log my food intake on my Fitbit and I was really surprised the first time I looked at the breakdown and saw how many carbs I was eating for someone who thought they were eating low carb.
They just don't come from the foods I used to get them from. I figured if my BG was ok then I must have been eating the right sort of carbs.
 
As far as meter goes, you'll find quite a few people on here use the Home Health UK code free meter and strips. The main reason is that you can get 50 test strips for 6.99. Have a look here: http://homehealth-uk.com/ . I switched from the Accu Check some time ago and , although the code free is not as sexy looking, I soon got used to it and now use it without thinking.
 
Lizzie2 said:
Thank OV, that's very useful to know. I love your avatar, there are some wonderful grumpy cats around. Cats don't even need a grumpy face to tell you how it is. I always knew when my cat used to turn his back in me and if he ruffled his fur while his back was turned to me then I knew I'd really upset him big time.
I log my food intake on my Fitbit and I was really surprised the first time I looked at the breakdown and saw how many carbs I was eating for someone who thought they were eating low carb.
They just don't come from the foods I used to get them from. I figured if my BG was ok then I must have been eating the right sort of carbs.
Click to expand...
I was surprised to discover that my morning noon and anytime mug of coffee was adding 5 to 7 g of carb a shot. Even whole milk has carbs. I recently switched to bulletproof coffee in order to gain weight (Yep it worked!) and this is low carb. i am now alternating since I no longer need extra calories, and am going lower carb. PS I never annoy our cats - cleaning up after they express their displeasure just ain't worth it
 
Dougie22 said:
As far as meter goes, you'll find quite a few people on here use the Home Health UK code free meter and strips. The main reason is that you can get 50 test strips for 6.99. Have a look here: http://homehealth-uk.com/ . I switched from the Accu Check some time ago and , although the code free is not as sexy looking, I soon got used to it and now use it without thinking.
Click to expand...
I use the SD Codefree too for the same reason wrt strip cost. But a word of warning. It is calibrated for plasma blood, and so will read 12% higher than the older meters. Mine constantly reads several points higher than my NEO, and is also more prone to misreads. For example, I start to get my hypo symptoms when my NEO shows 3.9 or lower, but the corresponding SD results on the same drop can be above 6 mmol/L So my NEO agrees with the published target ranges (NICE, DVLA), Daisy1), my SD is at least 2 points higher. i have had a difference of 5 mmol/Lbetween these two when my bgl was above 20. Not a misread since these meters track each other well, and are both meeting their accuracy requirements.
 
Oldvatr said:
I use the SD Codefree too for the same reason wrt strip cost. But a word of warning. It is calibrated for plasma blood, and so will read 12% higher than the older meters. Mine constantly reads several points higher than my NEO, and is also more prone to misreads. For example, I start to get my hypo symptoms when my NEO shows 3.9 or lower, but the corresponding SD results on the same drop can be above 6 mmol/L So my NEO agrees with the published target ranges (NICE, DVLA), Daisy1), my SD is at least 2 points higher. i have had a difference of 5 mmol/Lbetween these two when my bgl was above 20. Not a misread since these meters track each other well, and are both meeting their accuracy requirements.
Click to expand...

I'm confused.

You say the SD Codefree is calibrated for plasma blood.
I have found a couple of references that are contradictory.
http://sdbiosensor.co.kr/CodeFree_en
http://www.homehealth-uk.com/PDF Test Instructions/User_Guide_UK_final.pdf
(page 4 Your new meter is designed for testing fresh capillary whole blood samples)

So which is it?
 
@Lizzie2 I should be coming up for a HbA1c test soon and hope the result is as good as yours have been.

My problem is that it was about a year between my last HbA1c of 64 and actually being diagnosed and as for that year I was not testing I have no idea what my blood sugars where doing. So please do keep testing what ever the results.
Bluetit1802 said:
I'm confused.

You say the SD Codefree is calibrated for plasma blood.
I have found a couple of references that are contradictory.
http://sdbiosensor.co.kr/CodeFree_en
http://www.homehealth-uk.com/PDF Test Instructions/User_Guide_UK_final.pdf
(page 4 Your new meter is designed for testing fresh capillary whole blood samples)

So which is it?
Click to expand...
" SD CodeFree™ BLOOD GLUCOSE MONITORING SYSTEM 4 Understanding Your New System CHAPTER 1 : Understanding Your New System The SD CodeFree™ Blood Glucose Monitoring System 1. Before You Start Testing About the meter and test strips • It is very important to carefully read and follow the instructions in order to prevent an incorrect result or improper treatment. It is advisable to read all the pages before using the meter. The detailed instructions commence with “Inserting the Battery” on page 17. • The meter, test strips and control solutions are only for use outside the body (in-vitro). • Your new meter is designed for testing fresh capillary whole blood samples (for example, blood from your fingertip, palm, upper arm, or forearm). Only use SD CodeFree™ test strips. Other test strips will give inaccurate results. • Do not use the SD CodeFree™ blood glucose monitoring system for testing of serum or plasma or arterial, venous whole blood. • Inspect the container of test strips before using them for the first time. If you see any damage to the container cap or if anything prevents the cap from closing properly, do not use the test strips. Contact the SD Biosensor Customer Care Service Center. Damaged test strips can cause inaccurate results, which could lead to improper treatment."
 
Hi Lizzie, your current hba1c does not indicate that you are no longer diabetic, my own have been between 5.3 and 5.6 for the last 6 years or so but I am still a T2 diabetic, I am just a well controlled diabetic but I can still push my bg levels easily into double figures if I where to eat white bread or some other fast acting carbs.

I would also question the wisdom of not being honest with your diabetic nurse how can they help you if you dont tell them what you are doing to control your diabetes?

I dont eat LCHF and never have gone for the high fat bit_yuk! But I do eat a reduced carb diet and have been straight with my doc and my diabetic nurse from day one when I was on insulin and eating 60g carbs a day, I now eat a fair bit more but after losing 5 stone in weight in the first two years I can handle larger amounts than I used to be able to when I was first diagnosed.

I really think it is counter productive to tell porkies to your health care team, they are there to help you and you might be surprised at their attitude especially as you are getting such good results but by lying to them if something serious were to happen then how can they offer you any advice if they think you are following a totally different control plan to that which you have said you follow.

Tell them the truth, the worst that can happen is that they disagree with you but at least they will see the whole picture.

Hope this helps and congratulations on your control.
 
Bluetit1802 said:
I'm confused.

You say the SD Codefree is calibrated for plasma blood.
I have found a couple of references that are contradictory.
http://sdbiosensor.co.kr/CodeFree_en
http://www.homehealth-uk.com/PDF Test Instructions/User_Guide_UK_final.pdf
(page 4 Your new meter is designed for testing fresh capillary whole blood samples)

So which is it?
Click to expand...
In the leaflet that came with the meter it clearly states Plasma calibration. It is reading higher than my NEO~ which is whole blood calibrated, and also higher that my XCEED which is also whole blood, I have NEVER had my SD read lower than any of these meters. It meets its own calibration test solutions, so it is not a faulty meter, and so I was unable to obtain a replacement. Try ringing Homehealth directly, but even they may not know since all they do is import it and flog it.
 
Bluetit1802 said:
I'm confused.

You say the SD Codefree is calibrated for plasma blood.
I have found a couple of references that are contradictory.
http://sdbiosensor.co.kr/CodeFree_en
http://www.homehealth-uk.com/PDF Test Instructions/User_Guide_UK_final.pdf
(page 4 Your new meter is designed for testing fresh capillary whole blood samples)

So which is it?
Click to expand...
This text only states the meter is capable of reading these types of blood (true), but does not show whar calibration is used. My leaflet does. The text states <<or testing of serum or plasma or arterial, venous whole blood>> and plasma is very different calibration requirement to whole blood but it is a straightforward correction of 12% If you read this forum on Glucose Meters you will see many Codefree owners saying theirs read high compared to other meters. The SD should correlate to recent Accuchek meters since they too are now Plasma calibrated. (they changed from whole blood in 2011) Actually the text above is incorrect, because arterial venous whole blood is not what a fingerprick test is measuring. It measures interstitial fluid which used to be called whole blood, and venous blood is actually called plasma, Confusing.

So Plasma calibration makes a meter's readings correspond to lab results derived from the venous blood sample, but the whole blood calibration is a better guage of the interstitial fluid in the fingers. The NICE, DVLA et al published data refer to the older whole blood meters, and have not been updated for the newer plasma meters.
 
Oldvatr said:
In the leaflet that came with the meter it clearly states Plasma calibration. It is reading higher than my NEO~ which is whole blood calibrated, and also higher that my XCEED which is also whole blood, I have NEVER had my SD read lower than any of these meters. It meets its own calibration test solutions, so it is not a faulty meter, and so I was unable to obtain a replacement. Try ringing Homehealth directly, but even they may not know since all they do is import it and flog it.
Click to expand...

Well, the second link I gave, repeated by @JohnEGreen above, is exactly the same as in the leaflet I received with my Codefree. The leaflet was produced by the manufacturers (SD Biosensor).
It says it is designed for testing "fresh capillary whole blood samples" It goes on to say "Do not use for testing of serum or plasma or arterial venous whole blood"

No point in ringing Home Health - it is clear in their leaflet.
 
Sid Bonkers said:
Hi Lizzie, your current hba1c does not indicate that you are no longer diabetic, my own have been between 5.3 and 5.6 for the last 6 years or so but I am still a T2 diabetic, I am just a well controlled diabetic but I can still push my bg levels easily into double figures if I where to eat white bread or some other fast acting carbs.

I would also question the wisdom of not being honest with your diabetic nurse how can they help you if you dont tell them what you are doing to control your diabetes?

I dont eat LCHF and never have gone for the high fat bit_yuk! But I do eat a reduced carb diet and have been straight with my doc and my diabetic nurse from day one when I was on insulin and eating 60g carbs a day, I now eat a fair bit more but after losing 5 stone in weight in the first two years I can handle larger amounts than I used to be able to when I was first diagnosed.

I really think it is counter productive to tell porkies to your health care team, they are there to help you and you might be surprised at their attitude especially as you are getting such good results but by lying to them if something serious were to happen then how can they offer you any advice if they think you are following a totally different control plan to that which you have said you follow.

Tell them the truth, the worst that can happen is that they disagree with you but at least they will see the whole picture.

Hope this helps and congratulations on your control.
Click to expand...


It's ok Sid, no porkies at all - I was totally up front with her - I told her I was on LCHF - well it's actually carbs from vegetables rather than grains and I just don't worry too much about fat, I have never eaten fat in meat etc. She said 'ah so you've been eating a low GI diet' - she also knows I bought a BG meter and had been testing before and two hours after all of my meals and have been recording the results and eliminating anything that spiked my bloods, i just got the impression she wasn't too impressed about that.

I was never offered a BG meter - just told to concentrate on diet and exercise - to avoid grapes and pineapple and not to have more than one banana a day - I had been totally off cakes, sweets and and biscuits etc for the previous three months for other reasons by the time I saw her (I was taking steroids for something else and had gone completely off all that sort of stuff) and my diet seemed pretty good - it wasn't suggested I test my blood which was why after a week of reading up about T2 and a lot of deliberation I bought my own meter. I couldn't see how I could ever improve things if I didn't know what was going on inside. As it was it turned out that my healthy home made gluten free oat bran breakfast muffins, the odd slice of gluten free bread, jacket potatoes - my stand by lunch all spiked me and I think that after three months eating those 'healthy' foods plus loads of fruit my readings would still have been high.

I agree, although they have said I'm no longer T2 and I won't have another HbA1c for a year I look on myself as being clear at the moment but I feel that I'm only controlled and I could never go back to eating the things that affect me and if I do I imagine I would end up T2 again in no time.
 
Hi @Lizzie2 my hba1c has gone from 42 to 36 in the last 18 months however I was told by my DN that once a diabetic always a diabetic!
@Sid Bonkers when I told my DN that I was testing my BG with a meter her response was 'why do you want to give yourself sore fingers?' - some much for honesty!!
 
Oldvatr said:
Thus we can run with lower HbA1c levels, but there comes a point where we need to change things and have some carbs or extra protein to stave off the hypo's. Upping the fat will not do it since it cannot be used to replace the glucogen sources for the brain.
Click to expand...

Just like to point out that this may be true in the context of low carb/moderate fats diet, but those on ketogenic diet and striving to be keto adpated would view this a little differently...because they believe that eventually even the brain will be keto-adapted.
http://www.ketotic.org/2012/05/keto-adaptation-what-it-is-and-how-to.html

"When glycogen runs out, you start producing ketones, and some are excreted in the urine. This is easy to measure, and some keto dieters use it to know if they are hitting a low enough level of carbohydrate restriction. This also marks the beginning of the second stage of keto-adaptation. Ketones are now becoming available for fuel, but they haven't yet risen to their stable adapted level. There is an interesting interplay between ketone use in the muscles and the brain. When ketone levels are low, the muscles tend to use them directly for fuel, but as levels increase, the muscles use them less, turning to fat for fuel instead. The brain, on the other hand, uses ketones proportionally to their concentration in the blood. This means that at low levels of ketones, the brain's supply is not much affected, because the muscles intercede, but above some threshold, the brain's supply rapidly becomes much higher. At this point, the brain can rely on ketones, and since it is no longer susceptible to running out of fuel, the need to eat frequently throughout the day to maintain mental function disappears. The muscles in turn now rely on fat: they finally have access to a virtually unlimited supply of energy, which is particularly valuable for athletes."
 
kokhongw said:
Just like to point out that this may be true in the context of low carb/moderate fats diet, but those on ketogenic diet and striving to be keto adpated would view this a little differently...because they believe that eventually even the brain will be keto-adapted.
http://www.ketotic.org/2012/05/keto-adaptation-what-it-is-and-how-to.html

"When glycogen runs out, you start producing ketones, and some are excreted in the urine. This is easy to measure, and some keto dieters use it to know if they are hitting a low enough level of carbohydrate restriction. This also marks the beginning of the second stage of keto-adaptation. Ketones are now becoming available for fuel, but they haven't yet risen to their stable adapted level. There is an interesting interplay between ketone use in the muscles and the brain. When ketone levels are low, the muscles tend to use them directly for fuel, but as levels increase, the muscles use them less, turning to fat for fuel instead. The brain, on the other hand, uses ketones proportionally to their concentration in the blood. This means that at low levels of ketones, the brain's supply is not much affected, because the muscles intercede, but above some threshold, the brain's supply rapidly becomes much higher. At this point, the brain can rely on ketones, and since it is no longer susceptible to running out of fuel, the need to eat frequently throughout the day to maintain mental function disappears. The muscles in turn now rely on fat: they finally have access to a virtually unlimited supply of energy, which is particularly valuable for athletes."
Click to expand...
Yes, indeed. Keto diets have been used since 1922 for control of siezures in children, and although much of the evidence is anecdotal and not covered by RTC studies, there is evidence that a NC diet is possible. I include an article I found that gives a nice well presented discourse on this
http://www.neurorexia.com/2013/03/2...ular-neuroscience-look-at-the-ketogenic-diet/

ETA; Another somewhat technical article, but informative:
http://jissn.biomedcentral.com/articles/10.1186/1550-2783-1-2-7
 
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